Intestinal obstruction due to a large gallstone impacted in the lumen is rare enough to occasion considerable interest. The early recognition of the condition is of especial importance because of the dangers of delay in operation.

Courvoisier,1 in 1890, collected 131 cases of obstruction due to a gallstone. Wagner2 found a total of 334 cases on record in 1914.

In a study of 3,064 cases of intestinal obstruction, reported from seven hospitals in 1925,3 there were only 28 due to a gallstone. The most frequent causes were hernia, intussusception, carcinoma, adhesions, internal strangulation and volvulus.

The age at which obstruction from a gallstone usually occurred was between 50 and 70 years. It was more common in women, in whom the incidence was 191, than in men, in whom it was 71 (Wagner).

Gallstones may gain access to the intestinal tract by perforation from the gallbladder or by